Determine the quantity of the symptoms from the list below, then rate each on a 0 to 4 scale depending on your experience:
Symptom | 0 | 1 | 2 | 3 | 4 | Score |
---|---|---|---|---|---|---|
Itchy, watery eyes | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Itchy nose | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Sneezing | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Runny nose | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Hives | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Vomiting | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Nausea | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Diarrhea | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Rashes | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Stomach cramps | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Swelling | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Bloating | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Redness | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Pain | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Tongue swelling | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Cough | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Wheezing | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Loss of breath | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Chest tightness | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Headache | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Feeling lightheaded, faint, or blacking out | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Burning skin | not present, no problem/effect | slight/mild, barely noticeable | moderate, some difficulty in usual activities | severe, continuous, life-disturbing | very severe, continuous, pervasive, life-threatening | |
Total (__/88) |
The higher the score, the higher the severity of your allergic reaction.